ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Risk Factors, Temporal Dependence, and Seasonality of Human Extended-Spectrum β-Lactamases-Producing Escherichia coli and Klebsiella pneumoniae Colonization in Malawi: A Longitudinal Model-Based Approach.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 14 citations in OpenAlex.
- Evaluation of detection performance and cost-effectiveness of IDEXX Colilert-18 and ChromAgar for environmental surveillance of extended-spectrum beta-lactamaseMicrobiology spectrum · 2026Article
- Seasonality and other factors influencing hospital acquisition of multi-drug-resistant Enterobacterales colonisation: a one-year cohort study - Botswana, 2022-2023.Infection prevention in practice · 2026Article
- Animal husbandry and environmental conditions are associated with cefotaxime-resistantmedRxiv : the preprint server for health sciences · 2026Article
- Animal husbandry and environmental conditions are associated with cefotaxime-resistant Escherichia coli in yard soil in peri-urban Malawi.PLOS global public health · 2026Article
- Factors associated withSouthern African journal of infectious diseases · 2026Article
- Klebsiella pneumoniae species complex bloodstream infection in adult patients: changing epidemiology and determinants of poor outcomes.Infection · 2025Article
- Prevalence of ESBL-producingOne health (Amsterdam, Netherlands) · 2025Review
- Risk factors for household colonization by extended-spectrum cephalosporin-resistant enterobacterales (ESCrE) in Botswana.Antimicrobial resistance and infection control · 2025Article
- Risk Perception and Psychosocial Factors Influencing Exposure to Antimicrobial Resistance through Environmental Pathways in Malawi.The American journal of tropical medicine and hygiene · 2025Article
- Seasonal Determination of Antibiotic-Resistant Microorganisms and Ciprofloxacin Residues in Pork and Chicken Meats Collected from Fresh Markets in Chiang Mai, Northern Thailand.Foods (Basel, Switzerland) · 2025Article
- Key environmental exposure pathways to antimicrobial resistant bacteria in southern Malawi: A SaniPath approach.The Science of the total environment · 2024Article
- Deciphering the gastrointestinal carriage ofInfection and immunity · 2024Review
- Utilizing river and wastewater as a SARS-CoV-2 surveillance tool in settings with limited formal sewage systems.Nature communications · 2023Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundSub-Saharan Africa has the highest estimated death rate attributable to antimicrobial resistance, especially from extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). However, the dynamics of human colonization in the community with ESBL-E are not well described. Inadequate water, sanitation, and hygiene infrastructure and associated behaviors are believed to play an important role in transmission of ESBL-E, and an improved understanding of the temporal dynamics of within-household transmission could help inform the design of future policies.
methodsIn this 18-month study, using microbiological data and household surveys, we built a multivariable hierarchical harmonic logistic regression model to identify risk factors for colonization with ESBL-producing Escherichia coli and Klebsiella pneumoniae, reflecting household structure and temporal correlation of colonization status.
resultsBeing male was associated with a lower risk of colonization with ESBL-producing E. coli (odds ratio [OR], 0.786; credible interval [CrI], .678-.910), whereas the use of a tube well or a borehole was associated with an increased risk (OR, 1.550; CrI, 1.003-2.394). For ESBL-producing K. pneumoniae, recent antibiotic exposure increased risk of colonization (OR, 1.281; CrI, 1.049-1.565), whereas sharing plates decreased that risk (OR, 0.672; CrI, .460-.980). Finally, the temporal correlation range of 8 to 11 weeks provided evidence that within-household transmission occurs within this time frame.
conclusionsWe describe different risks for colonization with different enteric bacterial species. Our findings suggest interventions to reduce transmission targeted at the household level need to focus on improving water, sanitation, and hygiene infrastructure and associated behaviors, whereas at the community level, they should focus on both environmental hygiene and antibiotic stewardship.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.